| Objectives: To study the typical clinical features of hypertensive intracerebral hemorrhage(HICH)patients,analyze the expression of serum Netrin-1 at different prognostic levels,and finally elucidate the diagnostic value of serum Netrin-1 in the prognosis of patients with HICH.Methods: A total of 49 patients with HICH admitted to the Department of Neurosurgery of our hospital from September 2021 to September 2022 were randomly selected,46 patients with simple hypertension and 52 healthy people were collected in the control group who were examined in the physical examination center of our hospital during the same period,demographic data and clinical data were routinely collected from all enrolled research subjects,and serum Netrin-1 concentration was determined by enzyme-linked immunosorbent method.SPSS23.0 statistical software was used for data analysis.The t-test,ANOVA,chi-square test and Fisher exact test were used to analyze the difference of serum Netrin-1 under different NIHSS scores,prognosis and blood loss in patients with HICH.Pearson was used to analyze the correlation between serum Netrin-1 and inflammatory markers in patients with HICH.The logistic regression model was used to analyze the correlation between serum Netrin-1 level and poor prognosis in patients with HICH,and the diagnostic value and threshold of serum Netrin-1 level on poor prognosis in patients with HICH were analyzed by ROC curve.Results:1.There were no significant differences in the conventional demographic data of HICH patients,patients with simple hypertension,and healthy people,which was consistent with the characteristics of no difference in conventional data between comparison samples.2.In the serum Netrin-1 level,patients in the HICH group and the uncomplicated hypertension group were significantly lower than the normal population,and the patients in the HICH group were significantly lower than those in the simple hypertension group.3.The expression of serum Netrin-1 in the severely injured group and the moderately injured group was significantly lower than that in the mildly injured group.The expression of serum Netrin-1 in patients with high bleeding volume was significantly lower than that in patients with low bleeding volume.Serum Netrin-1expression in patients with a good prognosis was significantly higher than in patients with a poor prognosis.4.Among the inflammatory indexes,serum IL-6,CRP,procalcitonin,WBC and NEUT in patients with good prognosis were significantly lower than those with poor prognosis.Serum IL-10 and Netrin-1 levels were significantly higher in patients with a good prognosis than in patients with a poor prognosis.Among the bleeding sites,the incidence of deep cerebral hemorrhage and rupture into the ventricles in patients with good prognosis was significantly lower than that in patients with poor prognosis.The incidence of lobar hemorrhage,brainstem hemorrhage,and cerebellar hemorrhage in patients with a good prognosis was significantly higher than in patients with a poor prognosis.At the same time,the amount of bleeding in patients with good prognosis was significantly lower than in patients with poor prognosis.5.History of cerebrovascular disease(OR=0.945,95%CI=0.753-1.381,p<0.05),Netrin-1(OR=0.96795%,CI=0.945-0.990,p<0.05),NHISS score(OR=1.059,95%CI=0.826-1.623,p<0.05),deep cerebral hemorrhage(OR=0.743,95%CI=0.515-1.326,p<0.05),Ventricular rupture(OR=0.825,95%CI=0.631-1.458,p<0.05)was an independent factor in predicting poor prognosis in patients with HICH.6.The diagnostic value of serum Netrin-1 level for poor prognosis in patients with HICH was 0.933(95% CI=0.625-0.981),and the sensitivity and specificity were 88.9%and 95.5%,respectively,at the diagnostic threshold of 224.78 pg/ml.Conclusion:1.Serum Netrin-1 levels in HICH patients are inversely correlated with disease severity.2.Serum Netrin-1 has high specificity and sensitivity for predicting the prognosis of patients with HICH,which may be a potential biological marker for the prognosis of HICH.3.Serum Netrin-1 is negatively correlated with neurological inflammation in patients with HICH,which may play a potential protective factor in the prognosis of HICH. |
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